| NPI | 1992265763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFONSO ALLEN Owner 336-508-6582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 163W00000X Registered Nurse | |
| 251B00000X Case Management | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2019-03-20 |